| NPI | 1144664665 |
|---|---|
| Former Name | DEETTA KAY CLOUSE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: IN 28178817A) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IN 28178817A) |
| 163W00000X Registered Nurse (Licence: MO 2012023980) | |
| 163WH1000X Registered Nurse Hospice (Licence: KS 120654) | |
| 363LF0000X Nurse Practitioner Family (Licence: MO 2014002636) | |
| 363LF0000X Nurse Practitioner Family (Licence: KS 5376265111) | |
| 363LF0000X Nurse Practitioner Family (Licence: IN 71004949A) | |
| Enumeration Date | 2013-04-26 |
| Last Update Date | 2024-07-01 |